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Physical Therapy

The Young Athlete: Sports injuries in children are different than those in adults and a child’s rehabilitation process is different than that of their parents.  With more and more children specializing in one sport, repetitive injuries and underused muscles occur at a higher frequency. The physical therapists at Positive Steps Therapy work closely with one another as well as with local physicians to establish appropriate protocols for the return of their injured athletes to sports. Our therapists believe in active rest to condition the child and keep them healthy in the safest way possible in order to prepare them to return to their sport of choice.

We see children with a variety of sports and overuse injuries including though not limited to:

  • Stress Fractures
  • Severs Disease, Calcaneal Apophysitis
  • Sinding Larsen Johansson Disease
  • Little League Elbow
  • Osgood Schlatter Disease
  • Muscle strains
  • Myositis Ossificans
  • Ligament sprains
  • Joint dislocations
  • Patellofemoral pain syndrome
  • Spinal injuries
  • ACL injuries

The pediatric patient responds differently to injuries and their rehabilitation should be handled by those who know.


At Positive Steps Therapy, we are able to provide ongoing education and training for parents and children in the care of bracing.  Our physical therapists are available, working in concert with a child’s referring physician(s), to evaluate a child’s bracing needs.  Follow up appointments are conducted to ensure proper use and fit.  As the child develops, our team can evaluate if the brace is continuing to appropriately assist with a child’s ability to function, as well as make recommendations as appropriate.  Treatment will be based on our expert evaluation of your child’s condition and the likelihood for a good outcome.  If bracing and physical therapy are the prescribed option, we can offer a comprehensive functional plan.  Example diagnoses which require bracing include:  hypotonia, cerebral palsy, toe walking, and spina bifida to name a few.

Adaptive Equipment:

Whether it is at school, in their home, or out in the community, a child may benefit from the use of adaptive positioning, seating, and mobility devices.  This equipment can assist a child in maintaining upright posture to engage in activities, participate with peers, and improve overall body function by allowing various positions to maximize respiratory function, improve head and upper extremity control, and minimize the potential of muscle contractures or skin breakdown.

Our physical therapists are available to evaluate a child’s need for adaptive equipment.  They will assess the child’s positioning, posture, muscle control, and bony alignment, while working closely with the family and equipment vendors to achieve functional outcomes.  The therapist will provide input and recommendations based on the child’s needs and the family’s unique situation.  The physical therapists at Positive Steps Therapy will continue to reassess the child during their course of treatment or on an as needed basis to determine the current fit of the equipment and potential need for modifications as the child continues to grow and develop.


Plagiocephaly is also known as flat head syndrome, is a condition characterized by an asymmetrical distortion (flattening of one side) of the skull. It is characterized by a flat spot on the back or one side of the head caused by remaining in a supine position for too long.

Positive Steps Therapy is working closely with a local orthotist to provide improved care for children and families dealing with plagiocephaly.  Each of our outpatient offices is equipped with the ability to evaluate and measure children to monitor and determine their need for helmet therapy.  Physical therapists can be the first line of defense in educating families on positioning to minimize the need for helmet therapy.   Our therapists are well versed on the contraindications of helmet therapy and are knowledgeable in the need and appropriateness for referral to neurology.

Upon evaluation, physical therapists will:

  • Complete a thorough patient history
  • Measure head shape with calipers
  • Take photographs
  • Assess cervical range of motion and muscle strength

Based on measurements taken, the child’s age and documented parameters, interventions will be recommended for the child.

If helmet therapy is recommended, Positive Steps Therapy works with Boston Brace and National Rehab in which a portable scanner is used to measure and fit the child.

Massage Therapy:

Massage therapy is used for a variety of clients, such as children with cerebral palsy, autism, toe walking, and spasticity to name a few.

Benefits of massage include but are not limited to:

  • Calming a child
  • Decreasing anxiety
  • Improving muscle tone
  • Promoting good sleep habits
  • Increasing focus/sensory integration
  • Decreasing aversion to touch
  • Reducing pain
  • Improving flexibility and range of motion

Benefits of massage for newborns include but are not limited to:

  • Improving digestion
  • Stimulating nervous system to build muscle tone, coordination, and brain function
  • Increasing circulation
  • Calming to improve sleep habits
  • Boosting immune system
  • Healing from birth trauma

Occupational Therapy

Therapeutic Listening®:

Therapeutic Listening® is an evidence based protocol that can be implemented by therapists who have been specifically trained in utilization of the program.  Therapists can evaluate a child’s sensory processing needs, develop a child specific program, then implement Therapeutic Listening® in the clinic setting while advising families on how to carry over the program in their home environment.  Therapeutic Listening® combines a sound based intervention which utilizes electronically altered music on compact discs with traditional sensory integration treatment strategies.

Therapeutic Listening® in conjunction with sensory integration techniques tends to speed the emergence of some of the following:

  • Attention
  • Organized behavior
  • Self regulation
  • Fine motor control
  • Postural control
  • Oral motor/articulation
  • Visual motor integration
  • Social skills/communication
  • Praxis
  • Bilateral integration

The equipment required for listening therapy are headphones that meet specific requirements, a CD player with special features, and CDs that are electronically altered, based on the ideas and the technology created by Alfred Tomatis, Guy Beard, and Ingo Steinbach. Depending on the child’s treatment goals, the therapist will determine which music, modulation, and activities best suit the child and a program will be developed to specifically target the child’s unique needs.

For more information:

Handwriting Without Tears®:

Positive Steps Therapy takes pride in their use of the Handwriting Without Tears® (HWT) program.  Therapists strive to help children with difficulties developing or refining handwriting skills essential for achieving success.  The HWT program takes a multisensory approach to handwriting.  The program incorporates fun activities for all ages including, but not limited to:  the use of whole body movements, play dough, small writing utensils, stamp and see screen, music, worksheets, and wooden letter pieces.  The HWT program was designed to teach writing in a way that is both simplified and easy for children of all ages to learn print and/or cursive.  Our occupational therapists are all educated and trained on the use of this program.  Parents have reported improved performance both in the classroom and home environments with the HWT program.

In addition, Positive Steps Therapy now has an evaluation tool to look at all aspects of your child’s handwriting.  The Print Tool® is an assessment used for children of all ages to evaluate and remediate printing skills.  This evaluation is useful in determining where the therapist should start in the remediation process of handwriting.  The test looks at 7 components of handwriting including; memory, orientation, placement, size, start points, sequence of formation and control.  Therapists have the ability to adapt this test to your child’s needs and look only at specific criterion.  Scores reported from this test are easy for parents to understand and the evaluation can be completed before and after remediation to see the positive changes in your child’s handwriting.

For more information:

Feeding Programs

One-on-one intensive feeding session:

During a one-on-one feeding session, the licensed occupational therapist can assist a child with a wide variety of feeding difficulties and help them learn to enjoy their daily mealtime.  The therapist will work with a child on a structured feeding program designed specifically for their individual feeding concerns.  Such feeding issues may include but are not limited to:

  • Food refusal
  • Oral sensory sensitivity
  • Oral motor weakness and other oral motor delays
  • Limited food repertoire
  • Food phobias or anxieties

By addressing the individual needs of a child with feeding difficulties, the therapist can make mealtimes in both the home and community settings more enjoyable for a child and their family, as well improve the child’s nutritional health and address safety concerns for children with poor oral motor control.

Food Explorers Group: Food, Fun, and Friends!

The Food Explorers Group at Positive Steps Therapy is a unique program that allows children who have worked through many of their feeding difficulties in a one-on-one functional feeding program the opportunity to take their newly acquired feeding skills to the next level.  The group provides a safe, relaxed eating environment where the child can continue to build on their feeding skills with peer role models and the support and coaching of a licensed occupational therapist. In this small group setting, goals for children include:

  • Promoting social eating
  • Providing peer modeling for eating
  • Encouraging sharing and trying new foods
  • Increasing oral motor desensitization and oral motor control/strength
  • Increasing the feeling of control and decreasing food related anxiety related to mealtimes with children

Parents of participants in the group have noticed improved social eating in the school and home settings as well as an increased willingness to try new foods with less anxiety during the family daily routine.

Speech and Language Therapy

Social Language Groups:

Our speech-language therapists believe the best learning for social language skills is achieved in opportunities for social communication with peers. At Positive Steps Therapy, we provide just that atmosphere for our clients. Our social language groups are led by certified speech and language pathologists and provide children with social language needs the opportunity to develop those skills within a structured atmosphere. Our groups consist of approximately 2-3 children and goals are developed based on each individual child’s needs. Groups meet weekly and the children are provided with direct instruction of skills from their therapist, as well as opportunities for implementation within a structured setting. Extension activities and strategies are also provided for the home in order to improve carry-over of skills beyond the clinic setting.

Speech, Language, & Hearing Screenings: Our speech-language therapists believe that early intervention is key to the successful development of the whole child. For this reason, we have taken a proactive role in our community to provide speech, language, and hearing screenings to children ages three to six years. We currently collaborate with several local preschools and daycares in order to provide these screenings, which aid in the early identification of speech, language, and hearing disorders.  Screening procedures are conducted on-site during the regular school day and involve the use of both formal and informal assessments for speech sound production skills, voice, fluency, auditory processing skills, grammar, and overall language development. Formal audiometric screenings are completed with the use of a portable device and headset. Please contact us if you would like to request more information or to arrange a screening for your facility.